Certified Revenue Cycle Representative (CRCR) Practice Exam

What is the daily out-of-pocket cost for each lifetime reserve day used?

1. 25% of the current deductible amount

2. 50% of the current deductible amount

3. The full deductible amount

4. No cost incurred

The correct answer is: 50% of the current deductible amount

Each lifetime reserve day represents an additional day of hospitalization that can be used once the normal benefit period has been exhausted. The purpose of this feature is to provide additional coverage for extended hospital stays that may be necessary for a patient’s condition. In this context, when a lifetime reserve day is utilized, there is a daily out-of-pocket cost incurred by the patient, which is set at 50% of the current deductible amount. This cost structure emphasizes the insurance program's design to share the financial responsibility with patients for extended hospitalizations, thus ensuring that those who make use of additional days in care contribute to their costs based on the deductible framework. This out-of-pocket requirement helps limit insurance company exposure while still providing necessary care for patients who might need it beyond the standard coverage period. The percentage specifically being half of the deductible reflects a compromise between cost-sharing strategies in healthcare plans.